1.Effects of electroacupuncture on the elderly's postoperation cognitive dysfunction after general anesthesia
Wei ZHOU ; Jinyan QU ; Yaoxiong CHEN ; Furong LUO ; Xiaojie LIU ; Licheng CHEN
Chinese Journal of Physical Medicine and Rehabilitation 2014;36(5):372-375
Objective To study the effects of electroacupuncture (EA) on the elderly's postoperation cognitive dysfunction (POCD) after general anesthesia.Methods Patients who need to have surgical operation done for lumbar spinal stenosis were randomly divided into an observation group (electroacupuncture and routine intravenous anesthesia) and a control group (only routine intravenous anesthesia),and EA was administered to those in the electroacupuncture group for 30 minutes at an interval of 10 minutes,beginning at 30 minutes prior to routine intravenous anesthesia and lasted till the end of the surgery.The differences regarding intraoperative propofol and remifentanil dosage,cognitive function,the levels of serum interleukin-6(IL-6),interleukin-10 (IL-10) and S100-β were compared.Results The intraoperative propofol and remifentanil dosages in observation group were (6.54 ± 3.27) μg/(kg· h) and (3.67 ± 2.53) mg/(kg· h),respectively,while those in control group were (9.70 ± 4.82) μg/kg and (5.62 ± 1.73) mg/kg.The intraoperative propofol and remifentanil dosages in observation group were significantly lower than those in control group (P < 0.05).At 72 hours post-operation the incidence of POCD in observation group was significantly lower than that in control group (1 case,2.5% versus 8 cases,20%),while the MMSE score was higher in observation group than that in control group (25.7 ± 1.9 versus 23.2 ± 2.1).The post-operation level of serum IL-6,IL-10 and S100-β in observation group were significantly lower than that in control group (P < 0.05).Conclusion Electroacupuncture could significantly improve the elderly's postoperation cognitive dysfunction after general anesthesia.It could inhibit the excessive expressions of IL-6,IL-10 and S100-β,alleviate the brain damage and reduce the incidence of POCD.
2.A study of outer membrane protein and molecular epidemiology of carbapenem-resistantAcinetobacter baumannii
Qian LI ; Zhi LI ; Yan QU ; Hailing LI ; Jinyan XING ; Dan HU
Chinese Critical Care Medicine 2015;(7):611-615
ObjectiveTo study the characteristics of the distribution and drug resistance ofAcinetobacter baumannii, and the epidemiology of the main strains among wards and hospitals, and to investigate the role of outer membrane protein in producing resistance against carbapenems.Methods 145Acinetobacter baumannii strains were collected from July 2013 to July 2014 from Huangdao Hospital Affiliated to Qingdao University and 401st Army Hospital. Antimicrobial susceptibility test was carried out with K-B disk diffusion method. Enterobacterial repetitive intergenic consensus polymerase chain reaction (ERIC-PCR) was used for DNA typing and test of homology. The carO gene of outer membrane protein was amplified by PCR, and the outer membrane proteins were extracted by ultrasonication and ultracentrifuge method from 30 randomly selected carbapenem-resistantAcinetobacter baumannii and 17 carbapenem-sensitive strains. Sodium dodecyl sulfate-polyacrylamide gel electropheresis (SDS-PAGE) was used to analyze the expressions of outer membrane proteins.Results 145Acinetobacter baumannii strains were generally resistant to 16 common antimicrobial agents, with the highest susceptibility rate of 79.3% for minocycline, followed by susceptibility rate of 40.7% for amikacin. There were 128 carbapenem-resistant strains (resistance rate of 88.3%), 137 multidrug-resistant strains and 126 extensively drug-resistant strains. The detection rates of carO gene were 97.7%(125/128)and 17.6%(3/17) in carbapenem-resistant and sensitive strains respectively. Around position of relative molecular mass 47 000, 16 of 17 sensitive isolates were expressed this protein, while 20 of 30 resistant ones were detected nothing or fade; 13 of 17 sensitive isolates were expressed around position of relative molecular mass 37 000 and 29 000 while 25 were detected nothing or fade around position of relative molecular mass 37 000 and 23 were detected nothing or fade around position of relative molecular mass 29 000 in 30 resistant ones. 145Acinetobacter baumannii were classified into 8 types based on ERIC-PCR electrophoresis patterns, and the major prevalence types were type A (71 strains) and type E (37 strains).Conclusions Drug resistance of clinically isolatedAcinetobacter baumannii is a serious problem in two hospitals; drug-resistant strains are spread and epidemic among wards and hospitals. The carO gene of outer membrane protein is widespread in carbapenem-resistantAcinetobacter baumannii. The loss or fading of outer membrane protein may play an important role inAcinetobacter baumannii resistance to carbapenems drugs.